The present invention relates to a medical image creating system, a medical image creating method and a display controlling program, whereby diagnosis is conducted by using a radiographic image acquired by radiographing a patient.
A radiographic image acquired by using radiation such as X-rays is widely employed as a medical image for disease diagnosis. For example, so-called radiography has been used in such a way that X-rays, transmitted through an examined body, are exposed to a phosphor layer (fluorescent screen). Then visible light generated from the phosphor layer is exposed to film employing silver salt and the film is developed, similar to an ordinary photograph.
However, recently, a radiographic image creating method by which a radiographic image is directly picked up as digital signals with a radiation detector such as stimulating phosphor or an FPD (Flat Panel Detector) without using a film coated with silver salt has been popular. Various kinds of image processing have been used for acquiring a radiographic image for medical diagnoses.
Specifically, for example, a radiographic image transduction method which transduces visible light or infrared light into stimulation light, is disclosed in U.S. Pat. No. 3,859,527 and Tokkai Shyou 55-12144. This method uses a radiographic image transduction plate having a stimulable phosphor layer on a support. The radiographic image transduction plate having a stimulable phosphor layer on a support has accumulated radioactive energy which is emitted as a stimulating light by scanning the stimulable phosphor layer with stimulating light such as a laser beam of a prescribed wavelength. The stimulating light is applied to the plate with photoelectric transformation by using a photoelectric transformation element such as a photomultiplier to pick out the emitted stimulating light as an electric signal. The radiation, which has been transmitted through an examined body part is accumulated in the stimulable phosphor layer and corresponds to the radiation transmittance amount of each part of the examined body.
The radiographic image diagnosis system known as computed radiography (CR) is generally divided into two systems. One is a system dedicated to patient's standing and lying positions in which a stimulable phosphor plate is installed in the reading apparatus, and the other is a cassette type system combining a portable cassette storing a stimulable phosphor plate inside and a reading apparatus (reader) which reads the data after removing the phosphor plate from the cassette. The cassette type system are disclosed in Tokkai Nos. 2002-159476 and 2002-158820 for example.
This cassette type radiographic image diagnosis system will now be explained referring to FIG. 16. As shown in FIG. 16, conventional cassette type radiographic diagnosis system 1 is composed of a plurality of examination rooms in each of which radiographing apparatus 4, which radiographs examined body part M, is installed; and an operation space where image reading apparatuses, readers 2, are installed. Each reader 2 reads radiographic image data from portable cassette 17, in which a radiographic image transduction plate is housed. Each cassette 17 incorporates stimulable phosphor sheet 18, which absorbs radiation energy. In each examination room, a controlling apparatus (controller 3) displays the radiographic image, input of patient information and body part information, as well as controlling reader 2. Further, reader 2, controller 3, job manager 19 and study manager 20 are connected as a LAN via switching hub 5.
In the examination room, a patient is positioned between radiation source 16 and cassette 17. When radiation is irradiated via radiation source 16, stimulable phosphor sheet 18 in cassette 17 absorbs and stores a part of the radiation energy. After radiographing, this cassette is brought to the operation space and is put into reader 2, and reader 2 irradiates excitation light to expose stimulable phosphor sheet 18 in cassette 17 so that stimulable phosphor sheet 18 emits stimulable light corresponding to radiographic image information stored on it. A photoelectric transduction is applied to the emitted stimulable light to output it as digital image data after A/D conversion.
Controller 3 has a display means for input of patient information or body part information and confirmation of the read image, as well as controls reading operation of reader 2. In this display means, for example, screens are displayed in an order, such as the reception list screen displaying a list of registered patients, the registration/search screen for registration of a new patient or for searching for patient information by inputting certain search data, the body part selection screen for setting the body part information for the selected patient, the image display screen displaying a radiographed image, or an image created by applying image processing to a radiographed image, so as to realize a work flow from reading to confirmation of images. If the desired image is not obtained, the system is structured so that the screen is switched to the image processing adjustment screen to change the image processing conditions used for image processing and an adjustment operation of image processing can be performed until the desired image is acquired.
[Patent Document 1] Tokkai No. 2002-159476
[Patent Document 2] Tokkai No. 2002-158820
A large hospital typically has a plurality of radiographing apparatuses 4, readers 2 and controllers 3, where a plurality of radiologists operate radiographing apparatuses 4 and a plurality of doctors can diagnose by using radiographic images acquired by radiographing various body parts of a plurality of patients. In order to clarify the correlation between body part information and cassette 17, preventing mistaken images for diagnoses, either of two modes is employed. One is a mode in which radiographing is carried out after correlation between body part information and cassette 17 is registered as radiographing reservation information (pre-registration mode). Another mode is one in which correlation between body part information and insertion order of cassette 17 is registered as radiographing reservation information without registration of cassette 17 before radiographing (post-registration mode).
In the pre-registration mode, an operator first reads an ID label applied on cassette 17, inputs patient information and/or body part information, wherein the inputted body part information and the ID label are correlated to each other. Then, X-ray radiographing is carried out by using the registered cassette 17. The cassette 17, where a latent image has been formed, is inserted into reader 2, which reads the ID label of cassette 17 and a set of body part information corresponding to this ID label, thereby acquiring reading conditions from the parameter set. Further, according to the acquired conditions, an image is read and is sent to controller 3 together with the cassette ID. Controller 3 correlates radiographing reservation information and the read image, employing cassette ID as a key, and displays the image after image processing according to the radiographing condition parameters.
In the post-registration mode, X-ray radiographing is carried out first and then, each inputted body part and the cassette insertion order are stored and correlated to each other. In addition, patient information or body part information are inputted. Cassette 17, where a latent image has been formed, is inserted into reader 2, which reads out body part information or the radiographing condition parameter set corresponding to the insertion order and acquires the reading conditions from the parameter set. Further, an image is read out according to the acquired reading conditions and sent to controller 3, which displays the image after conducting image processing according to the radiographing condition parameters.
The pre-registration mode and post-registration mode are effective methods in a large hospital. However, according to a survey of the inventors of this invention, in small medical practitioner's clinics, the number of operators for radiographing apparatus 4 is normally one or two, and radiographing of a plurality of body parts or a plurality of directions is seldom carried out. Further, the number of doctors who diagnose by using radiographic images is usually one or two, and still further, the number of radiographing apparatuses 4, readers 2 and controllers 3 is also small. Accordingly, it is unlikely that images are miscorrelated in a small medical practitioner's clinic, and therefore the above pre-registration mode or post-registration mode is sometimes inconvenient.
Specifically, in clinics of few medical practitioners, where the number of patients is few or radiographing demand is small at a time, it is easy to know which patient was radiographed, how many radiographs were taken and the image of which patient is being shown. It is therefore not critical to read the ID number on cassette 17 or to correlate the insertion order. It is usually sufficient to correlate patient information after displaying the read image or when the image is stored in a database. Accordingly, a system including modes which can be easily used by any scale of medical facility, whether a large hospital or a small medical practitioner's clinic is desired.